CRPS is a chronic pain condition. Swelling and redness, in addition to pain that is out of proportion to a limb or nerve injury, are the first signs that more may be wrong than the initial injury. If CRPS is diagnosed quickly, and treatment is started within a few months, the condition can be improved and possibly put into remission.
Physicians often recommend a combination of physical therapy and medication to combat CRPS. In combination with a healthy diet and exercise, many patients quickly find relief from symptoms. Relieving the symptoms is a good first step in managing CRPS, as the pain often makes it unbearable for patients to continue normal daily routines and activities. This can lead to depression, weight gain, and a host of other conditions that will make it even more difficult to treat CRPS.
Use of Physical Therapy to Treat CRPS
The first thing that a patient who has been diagnosed with CRPS should ask a physical therapist before beginning treatment is if they are experienced with CRPS or RSD, as it is sometimes called. The reason for this is that CRPS reacts differently to certain forms of treatment than other ailments or chronic pain syndromes. A therapist that is familiar with the disease is less likely to recommend forms of therapy that may worsen symptoms.
Ice should never be used to treat CRPS. Any form of cold therapy should not be used for CRPS, as it can worsen the symptoms and speed patients through the stages of the disease. Application of any type of a cold compress to an area that is affected with CRPS reduces blood flow to the area. It also damages the myelin sheath surrounding the nerve tissue and constricts blood vessels. CRPS makes it difficult for the blood vessels and myelin sheath to recover, possibly causing nerve and blood vessel damage and further aggravating the condition.
Treating CRPS with Physical Therapy
There are different types of physical therapy that are used to treat CRPS. As the patient’s condition improves, the program of therapy may be altered to further improve limb mobility and increase strength. Physical therapy may be combined with drug therapies or alternative treatments for CRPS and RSD management.
Aqua Therapy
Using a lap pool or deep water pool is a common way to begin physical therapy with patients that have been diagnosed with CRPS. The water serves to assist by taking some of the pressure off of joints, allowing patients to move more freely.
The water also adds a degree of resistance, helping to strengthen muscles. The water does not need to be any specific temperature, and some experts have found that changing the temperature of the water throughout the session will help the patient overcome sensitivity to temperature.
Lap pools are used to improve the patient’s balance and make it easier to complete weight bearing exercises. Deep water pools are used to strengthen the core muscles. The patient must tread water or complete the exercises while wearing a flotation device.
Desensitization Techniques
The therapist may use techniques to reduce the patient’s sensitivity to touch. This is typically done by starting with a very gentle touch, and gradually increasing the pressure over time until normal touches no longer cause the patient pain.
Exercise
This should be done only under the guidance of a therapist, as the therapist can work with the patient to show them proper techniques for strengthening the limb or area affected by CRPS. The therapist can ensure that the patient is not attempting exercise that may cause injury, or taking too much on. The therapist can also encourage the patient not to shy away from exercises that would be very beneficial because of pain. Patients often start with aqua therapy and gradually work into land-based forms of
exercise.
A physical therapist that is familiar with CRPS can also help patients learn techniques and ways to move to complete normal daily activities, help patients figure out how to pace their activities so that they are not run down, and provide feedback on improvement or digression of the condition.
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Kirkpatrick, Anthony, ed. “Treatment.” International Research Foundation for RSD/CRPS. International
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http://www.rsdfoundation.org/en/en_clinical_practice_guidelines.html.
Collins, Cristiana. “Physical Therapy Management of Complex Regional Pain Syndrome I in a 14-Year-Old
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